Clinical Atlas OS

Symptom pathway

Emergency

Chest Pain

Chest pain is one of the highest-stakes search intents in medicine. The key job is to separate immediately dangerous causes such as acute coronary syndrome, pulmonary embolism, aortic dissection, and pericardial disease from lower-risk mimics without losing time.

Back to symptoms Search MedVellum

4

Red flags

6

Differentials

4

Pathways

Rule out danger first

This pathway is organized around escalation, first-pass differentials, and linked topics rather than a flat list of causes.

Red flags

Haemodynamic instability, hypotension, syncope, or new shock
Tearing pain radiating to the back, pulse deficit, or neurological features
Severe dyspnoea, hypoxia, pleuritic pain, or haemoptysis
ECG changes, arrhythmia, or persistent ischaemic symptoms

Common causes to keep in the differential

Acute coronary syndrome

Aortic dissection

Pulmonary embolism

Pericarditis / myocarditis

Pneumothorax

GORD / oesophageal pain / musculoskeletal chest wall pain

Linked MedVellum pathways

Acute myocardial infarction

STEMI/NSTEMI framing, reperfusion, and complications.

Pulmonary embolism

Risk, diagnosis, imaging, and anticoagulation.

Pericarditis

Classic pleuritic pain, ECG changes, and recurrence risk.

Aortic dissection search

Jump into dissection content through the topic search.

Next practical steps

Start with instability, ECG, troponin timing, and bedside observations.
Use the linked topics to compare ACS, PE, dissection, and pericarditis.
Escalate immediately when symptoms are ongoing or physiology is abnormal.

Search the full library

Use MedVellum search when the presentation is mixed, atypical, or you need a broader differential before narrowing into a topic page.

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